Provider Demographics
NPI:1902513336
Name:BUTLER, JARRYD WILLIAM (PA)
Entity type:Individual
Prefix:
First Name:JARRYD
Middle Name:WILLIAM
Last Name:BUTLER
Suffix:
Gender:M
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:1421 NELSON ST UNIT B232
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-4552
Mailing Address - Country:US
Mailing Address - Phone:303-887-7022
Mailing Address - Fax:
Practice Address - Street 1:1421 NELSON ST UNIT B232
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-4552
Practice Address - Country:US
Practice Address - Phone:303-887-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-04
Last Update Date:2023-02-15
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant